As monotherapy, diuretics are as efficacious as drugs from each of the other commonly used classes of antihypertensive drugs - alpha and beta blockers, ACE inhibitors, calcium channel antagonists and `centrally acting' drugs - L.M.H. Wing
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As newer antihypertensive drugs have been introduced and heavily promoted for the treatment of hypertension, the continuing role of the thiazide diuretics has been questioned. This questioning is fuelled by a popular misconception that thiazides are not as potent as other antihypertensives, have unacceptable biochemical adverse effects and are associated with negative effects on cardiovascular risk factors such as increases in plasma cholesterol and impairment of glucose tolerance. The image of diuretics as antihypertensive drugs has not been helped by their lack of promotion by the pharmaceutical industry.